Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.
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Are Amalgam Fillings Safe?

Friday, 17 Sep 2010 09:16 AM


Question: I have read that amalgam fillings are not safe. What can happen? I think they are causing issues with me.

Dr. Hibberd's Answer:

There is no evidence that silver dental (amalgam) fillings pose a serious health risk for those that have them. Amalgams are metallic compounds that contain up to 50 percent mercury combined with silver, copper, and tin. This hardened mixture makes the mercury less absorbable by the body than the kind found in fish, though elemental mercury is emitted in minute amounts as a vapor from the amalgam.

The National Institutes for Health (NIH) states that "because vapor emitting from amalgam restorations can be absorbed by the patient through inhalation, ingestion, or other means, concerns have been raised about possible toxicity. At present, there is scant evidence that the health of the vast majority of people with amalgam is compromised, nor that removing amalgam fillings has a beneficial effect on health."

The FDA recommends that mercury fillings "may pose a safety concern for pregnant women and young children.” That doesn't mean it truly harms, and the FDA advises against removing existing fillings. There are some countries that limit amalgams, either as a precaution in pregnant women and small children or because of environmental concerns.

Properly applied amalgams are inexpensive and may last 10 to 15 years or more.

There continues to be much discussion of trace exposure to mercury by dental amalgams. Mercury is present in our environment, and we should minimize our exposure to it as it tends to accumulate in our bodies. Avoid handling the mercury from a broken thermometer.

In fact, arrange to have this removed professionally if it spills, as it will hide in crevices and emit mercury vapor for an extended period. I recommend that no mercury thermometers be used in the home because of this obvious hazard. Do not throw them in the trash. You can easily arrange to have them recycled as hazardous waste.

The National Toxicology Program of the National Institutes of Health has an excellent publication (go here) that says, "The FDA and EPA recommend pregnant women and young children reduce their exposure to mercury by avoiding eating fish known to contain elevated levels of mercury such as swordfish, shark, king mackerel, and tilefish.”

The publication adds that "women and children can eat up to 12 ounces (two average meals) per week of fish containing lower levels of mercury, such as shrimp, canned light tuna, salmon, pollack, and catfish. Also be aware that "albacore tuna contains higher levels of mercury, and it is recommended that no more than 6 ounces of this be eaten per week."

Now while this heavy metal has no real safe range, its use in amalgams has not been proven to harm our health in any way we can measure, and there is no mass recall to remove them now that other mercury-free substances are available. But our environment also exposes us to trace amounts of mercury, so we should avoid further exposure if at all possible from all sources.

The cost-benefit ratio fails when it comes to replacing all the amalgams in most people's mouths, yet many dentists will be pleased to offer this service at significant cost that is usually not covered by your dental or health insurance companies.

Fortunately, simple blood or urine tests are available to measure mercury levels in our bodies, as well as tests to measure the amount of mercury in our hair. Your doctor can take samples and have them tested.

It sounds like you would benefit by testing, but use that information wisely. Remember that you must include food and environmental sources of this heavy metal when you make any decisions if your mercury level is elevated. I wish you well.



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